Online Risk Behaviors and Their Associations with Depression, Suicidality, and Nonsuicidal Self-injury in Adolescents with versus without Attention-deficit/Hyperactivity Disorder

Abstract Objectives: In the present study, we intended to investigate differences in the rates of several online risk behaviors between adolescents with versus without attention-deficit/hyperactivity disorder (ADHD) and to examine the associations of online risk behaviors with depression, suicidality, and nonsuicidal self-injury among these adolescents. Methods: We included 349 adolescents aged 11–18 years (176 with and 173 without ADHD). Participants’ experiences of 13 online risk behaviors were examined. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. Suicidality was assessed using the suicidality domain of the epidemiological version of the Kiddie Schedule for Affective Disorders and Schizophrenia. Nonsuicidal self-injury was also assessed using a copy of self-reported questions. The associations between online risk behaviors, depression, suicidality, and nonsuicidal self-injury were examined. Results: No differences in the rate of online risk behaviors were observed between adolescents with versus without ADHD. Passive exposure to sex-related online content was significantly correlated with depression (odds ratio [OR] 95% confidence interval [CI]) = 3.118 [1.388–7.002], p < 0.01) and nonsuicidal self-injury (OR [95% CI] = 2.665 [1.191–5.966], p < 0.05). Active exposure to sex-related online content was significantly correlated with suicidality (OR [95% CI] = 2.694 [1.236–5.872], p < 0.05). Passive exposure to online content related to self-harm was significantly correlated with nonsuicidal self-injury (OR [95% CI] = 3.378 [1.093–10.444], p < 0.05). Conclusion: Online risk behaviors, especially exposure to content related to sex and self-harm, were found to be associated with mental health problems in adolescents.